A Case of Trichilemmal Cyst Developed on the Shin / 대한피부과학회지

No abstract available.

A Case of Clear Cell Basal Cell Carcinoma / 대한피부과학회지

Clear cell basal cell carcinoma is a rare histological variant of basal cell carcinoma, which is characterized by a variable component of clear cells. We report a case of clear cell basal cell carcinoma in a 53-year-old Caucasian male presented with a red 0.7x0.6 cm sized nodule with central bleeding on left cheek for 2 years. Histological examinations showed multiple dermal tumor lobules nested with basaloid cells of a peripheral palisading pattern. In addition, prominent clear cell changes were observed in the center of large nests. The clear cells showed a single large vacuole in their eosinophilic and granular cytoplasm with eccentric condensed nucleus. The clear tumor cells was stained with periodic acid Schiff and showed incomplete diastase-resistance. Intercellular mucin staining with alcian blue was positive. The tumor was successfully treated with Mohs micrographic surgery and no recurrence has been observed for 6 months.

Tuberculoid-type Leprosy Mimicking Tinea Corporis / 대한피부과학회지

A 59 year-old man developed a large, reddish, well-defined, scaly patch on his submental area 37 years before visiting our department; the patch showed central atrophy and was enlarged. He was erroneously treated for tinea corporis at private clinics for 5 years before the correct clinicopathological diagnosis of tuberculoid-type leprosy was made. We report this case to suggest that dermatologists should play an important role in the diagnosis and treatment of leprosy, and that they should pay careful attention while diagnosing new cases of leprosy.

Solitary Plaque Nevus Lipomatosus Cutaneous Superficialis on the Face / 대한피부과학회지

Nevus lipomatosus cutaneous superficialis (NLCS) is an uncommon form of connective tissue nevus, which is manifested principally as the deposition of fatty tissue in the dermis. Lesions almost always arise unilaterally on the thigh or buttock. Although NLCS can affect any region of the skin, only five cases of NLCS on face have been reported. A 48-year-old female presented with a skin-colored, 1 cm sized, soft and edematous plaque on the right malar area. The histopathologic findings showed scattered ectopic fat lobules between collagen fibers in the mid to deep dermis. We herein reported a case of solitary and plaque-shaped NLCS on the malar area.

A Case of Traumatic Neuroma Probably Originated from Dorsal Digital Nerve / 대한피부과학회지

Neuromas are hyperplasia of axons and associated nerve sheath cells. Cutaneous neuromas are rare. Neuromas can be classified into three types: traumatic neuromas, solitary palisaded encapsulated neuromas, and multiple mucosal neuromas. Traumatic neuromas are tangles of neural fibers and connective tissue that develop following nerve injury. These usually present as a solitary, skin colored or pinkish, slowly growing, palpable and painful firm papule or nodule. A 15-year-old female patient presented a solitary 1.0x0.5 cm sized, pinkish palpable well-demarcated firm subcutaneous nodule on the right third proximal interphalangeal joint. We herein report a case of traumatic neuroma which probably originated from the dorsal digital nerve.

Differences in Antigen-presenting Cells between Normal and Systemic Contact Dermatitis Skin due to Rhus Lacquer / 대한피부과학회지

BACKGROUND: Urushiol is a widely known potent allergen that causes severe contact dermatitis through the epidermis or blood vessels. The role of antigen presenting cells (APC) in allergic contact dermatitis (ACD) is well known, but the role of APC in systemic contact dermatitis (SCD) is not yet fully evaluated. OBJECTIVE: The aim of this study is to observe the changes of APC in thenormal and SCD skin and to discuss their possible roles in the disease process. METHODS: Immunohistochemical differences of the Langerhans cells (LC) and dermal dendritic cells (DDC) were investigated in cases of the normal and SCD skin (Ed note: keep uniformity as above). Immunohistochemical staining with anti-CD1a, S-100 protein, HLA-DR, and factor XIIIa antibodies were performed. The number of CD1a, S-100 protein, and HLA-DR positive cells per mm2 of the epidermis was counted. The number of HLA-DR and Factor XIIIa-positive DDC per mm2 was also evaluated. RESULTS: The LC positive for CD1a and S-100 in the epidermis were slightly higher in SCD, but their difference was not statistically significant. HLA-DR and Factor XIIIa-positive DDC in the dermis weresignificantly increased in the skin of SCD than normal. HLA-DR positive LC in the epidermis was also increased. CONCLUSION: Our results suggest that DDC plays a more important role than that of epidermal LC in urushiol-induced SCD. Increased HLA-DR-positive LC in the epidermis suggests that antigen delivery through the blood also affects the epidermal Langerhans cell beside the dermal dendritic cells.

Pincer Nail Deformity Treated with Widening of the Nail Bed / 대한피부과학회지

Pincer nail deformity is a nail deformity characterized by a transverse overcurvature of the nail plate, which increases along the longitudinal axis. Many conservative and surgical treatment modalities have been reported. Conservative methods can be difficult to use in cases of severe deformity because of their high recurrence rate. Therefore, surgical techniques, including nail matricectomy or correction of the nail bed, have been preferred in these cases. Matricectomy is generally considered as the surgical treatment of pincer nail deformity because of low recurrence rate in the field of dermatology. However, poor cosmetic results (e.g. narrowing of nail plate) are frequently observed. We present here a case of pincer nail deformity in the left great toe in a 57-year-old man who was treated successfully with widening of the nail bed without matricectomy. This method is an effective surgical technique preserving the nail matrix for the correction of pincer nail deformity.

Malignant Fibrous Histiocytoma on the Face / 대한피부과학회지

Malignant fibrous histiocytoma (MFH) is an aggressive soft-tissue sarcoma that most commonly occurs in the skeletal muscle of the extremities or retroperitoneum of the middle and late adulthood. We present a case of a 65-year-old woman who was presented with an asymptomatic erythematous nodule with central erosion on left temporal area. She was diagnosed with MFH, and then underwent Mohs micrographic surgery and flap coverage. No sign of metastatic recurrence was noted during the 6 month follow-up period.

Syringoid Eccrine Carcinoma on the Dorsum of Hand / 대한피부과학회지

No abstract available.

Painful Nodular Chancre of the Lower Lip / 대한피부과학회지

No abstract available.

Eccrine Poroma Presenting as Pedunculating Mass on the Flank / 대한피부과학회지

Eccrine poroma is a benign neoplasm, arising from the eccrine sweat duct. It generally occurs in middle aged individuals and is most commonly found on the sole or the sides of the foot, followed by the hands and fingers. It presents as a solitary, soft or a rather firm consistent, sessile or often slightly pedunculating, tumor. A 47-year-old woman presented with a 2.5x1.5 sized brownish to erythematous pedunculating mass on the left flank. According to histopathologic finding and immunohistochemical staining (epithelial membrane antigen), the final diagnosis was consistent with eccrine poroma. We report here on an interesting case of eccrine poroma presenting as pedunculating mass on the flank, which is an unusual location.

Unilateral Acanthosis Nigricans on Non-flexural Area / 대한피부과학회지

Unilateral acanthosis nigricans (AN) is an exceedingly rare disorder, probably viewed as a nevoid disorder and sometimes called nevoid AN, which is characterized by hyperkeratosis, papillomatosis and moderate acanthosis. The lesions of unilateral AN are distributed unilaterally and morphologic features are similar to other forms of AN. It is not associated with a syndrome, endocrinopathy, drugs or cancers. Here we describe a case of unilateral AN in a 16 year-old Korean man who presented with a broad ashy brown hyperpigmented, confluent hyperkeratotic plaque on the right posterior thigh.

Axillary Hidradenitis Suppurativa Treated with a Split Thickness Skin Graft after Wide Excision / 대한피부과학회지

Hidradenitis suppurativa is a chronic, relapsing suppurative disease of the apocrine sweat glands that principally affects the axillary and anogenital regions. The etiology of this disorder remains unknown. As conservative treatment usually does not prevent recurrence, surgical treatment is the method of choice, particularly for advanced case. We report a 25-year-old male patient who presented with a 7-year history of abscesses with foul-smelling discharge from his axilla. After failed medical therapy, he was referred for surgery. We performed a wide excision of the axilla with a split thickness skin graft after 1 week. The patient has been doing well, and there has been no relapse for about ayear after the operation.

Crusted Scabies Misdiagnosed as a Cutaneous Side Reaction due to Allopurinol in a Patient with Acquired Perforating Dermatosis / 대한피부과학회지

Crusted (Norwegian) scabies is a clinical variant of human infestation with Sarcoptes scabiei, and is characterized by extensive, heavily crusted skin lesions. It usually affects immunocompromised patients. The diagnosis is commonly missed, and can lead to mismanagement. Here we report a case of crusted scabies misdiagnosed as a cutaneous side reaction due to allopurinol in a 48 year old male patient with acquired perforating dermatosis who had been treated with allopurinol for about 20 weeks. The lesion showed pruritic, excessive hyperkeratotic scaly crusts and fissures on the hands, and on pelvic, genital and inguinal areas. His skin lesions disappeared after treatment with 10% crotamiton cream for 2 weeks.

Classic Type Ehlers-Danlos Syndrome with Cutis Laxa-like Histopathologic Findings / 대한피부과학회지

Ehlers-Danlos syndrome is a connective tissue disorder that is characterized by hyper-extensible skin, hyper-mobile joints, fragile tissues, bleeding diathesis and poor healing of wounds with "cigarette paper" scar formation. Cutis laxa is also a disease of the elastic fibers of the connective tissue and characterized by loose skin folds over all parts of the body, a prematurely aged appearance, a hooked nose with a short colummella and umbilical/inguinal hernias. We report here on two patients who showed the symptoms of Ehlers-Danlos syndrome with histopathologically reduced and distorted elastic fibers, which is usually seen in cutis laxa.

Localized Cutaneous Infection due to Scedosporium apiospermum / 대한의진균학회지

Scedosporium(S) apiospermum is the asexual stage of Pseudallescheria boydii. The organism has been isolated from polluted water, soil, sewage and potted plants in a hospital with low virulence. This ubiquitous fungus causes not only mycetoma, but also infections of variety of body sites including the skin. Localized skin infection without grain production due to this organism is much rarer than mycetoma. Infection may occur via direct inoculation and usually affects the extremities. We report a case of localized cutaneous infection due to S. apiospermum which occurred in a 79-year old female. She presented multiple erythematous papulopustules on the right wrist. Culture isolation for definitive diagnosis showed S. apiospermum. The patient was treated successfully with oral itraconazole 200 mg daily for 4 weeks.

Frequently Relapsing Secondary Cutaneous Diffuse Large B-cell Lymphoma in the Skin / 대한피부과학회지

We report a case of cutaneous diffuse large B cell lymphoma in a 66-year-old male who had a 5-year history of diffuse large B cell lymphoma on the left inguinal lymph node. The patient visited our clinic for the first time for relief of a non-tender well-defined erythematous hard nodules on the left foot and left thigh that had been present form 6 months and 1 month, respectively. Histologic examination revealed diffuse dense infiltration of large neoplastic lymphocytes with scanty cytoplasm and large nuclei. They showed a positive reaction to CD20 and CD79a, suggesting a B cell lineage. The patient was diagnosed with secondary cutaneous diffuse large B cell lymphoma. After 1 month of radiation therapy, complete remission was achieved. Five and seven months later, the patient returned foe relief of non-tender red-to-brown hard nodules on the left and right thigh, respectively. Histologic examination and immunohistochemical stain prompted the same diagnosis as previously. After radiotherapy and chemotherapy, the skin lesion was nearly resolved, and no evidence of extracutaneous involvement has been noted since.

Erythrokeratodermia Variabilis with Congenital Deaf-Mutism / 대한피부과학회지

Erythrokeratodermia variabilis is a rare genodermatosis characterized by the coexistence of randomly occurring, transient, erythematous patches and hyperkeratosis of the skin. A 25-year-old Uzbekistanian female with congenital deaf-mutism presented with well demarcated geographic hyperkeratotic patches and bizarre erythema on the whole body surface except the face, hands and feet from birth. The histopathological examination revealed marked hyperkeratosis, moderate acanthosis in the epidermis and vascular dilatation with a perivascular infiltration of inflammatory cells in the upper dermis. Herein we report on a rare case of erythrokeratodermia variabilis with congenital deaf-mutism which was rapidly improved by administering acitretin.

Correction of Pincer Nail Deformity Using Dermal Grafting

Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity.